Not Being the Thinnest Any More—How to Adjust

When you’re recovering from anorexia, it’s one of the most frightening things in the world to realise that you’re no longer the thinnest person in the room. And for it suddenly to be true not just once, but usually. After years of starving yourself, followed by months of regaining the weight you lost in anorexia, there comes a point where you realise that your body no longer looks anorexic: your bones aren’t visible as they used to be, you don’t look brittle enough to break in two, your muscles aren’t wasted away right down to the bone, your face isn’t any longer remarkable mainly for the hollows round the eyes or the concave lines where your cheeks try to connect up with your chin. Maybe you loved those things, or thought you did; maybe you knew you hated them, but you loved and needed what they represented: the illusions of control, strength, and purity that felt so special and precious to you. In any case, when you decided to get better, you decided to obliterate them: to let a protective layer of fat cover your bones and organs again, to let the muscles rebuild themselves, to become again someone that people—and you yourself, in the mirror—can see not as just a sick person but as a person with other, more interesting and less saddening qualities.

But having decided to let, and make, these changes happen doesn’t mean you’ll find it easy when they do, so I thought I’d offer a few thoughts about how to make it a little bit easier. My thoughts split into two strands: the strand that says be gentle and patient with yourself, and the strand that says simply stick rigidly to your plan (i.e. keep eating). They can require somewhat different attitudes, but they come together in the importance of just waiting it out, and waiting for it to be better.

I’ll begin with a diary entry from Christmas Day of 2008, which was a day I remember vividly as one when my new body (I’d been eating more since mid-July, and I weighed about 52 kg, with a BMI of about 18.5) felt very alien to me. The things I wrote then bring together some of what I want to talk about now.

Thursday 25th December 2008, 11:56 pm

Difficult. Lovely food, & I’ve eaten too much—i.e. the right amount, a good amount for Christmas; but the aftermath—or rather, the lull between dinner proper & the leftovers I ate more ravenously & uncontrollably—was difficult, & D [who would soon become my boyfriend] had to help me through it. Or rather, he didn’t have to—but he was able to; & I feel calmer & better for his having rung & texted. I was captivated by one of the awful Corfu photos of me & Sue [my mother], comparing it with those taken on North Sands this morning. I looked deathlike then I know; but can’t help staring, & longing with a great insidious part of myself to be her again. That other sexless joyless creature. D was shocked—had tears in his eyes, he said, when he saw it; a concentration-camp survivor; someone he’d never dare touch—nor one, I said, who would want to be touched by him. I feel again I’ve burdened him with my past; but it’s felt real today, the fear, as I see my fat puffy face in photos where my bones used to give it definition. But he says he likes curves not angles. And Tom [my father] has given me a beautiful dress—yet another long sleeveless thing, wine-coloured silk […]; & I could try on the dress & parade around in it without embarrassment about my arms [being too thin]—even if the photos I thought appalling.

The first thing to be aware of is that everyone in recovery has moments, even whole days, when they feel disgusted by their new, bigger body and long for their former smaller one, when however often they recite all the good reasons for regaining weight, and all the things that this process is and represents besides gaining fat, none of it has any force against the sheer overwhelming feeling of being fat, ungainly, in the wrong body. Sometimes, the only thing to do is cling on to those mantras you should have developed for yourself—all the reasons why anorexia made life intolerable, and all the physical and thereby psychological restoration that the higher numbers on the scales or the tape measure represent—and to wait for the awfulness to pass, which it will, as everything does.

Five months into recovery

That’s for the worst times. For the rest, and to pre-empt those, a few other thoughts might help. Perhaps most importantly of all, be patient. This all takes time. The early stages of rehydration and restoration of fat deposits may be uneven—you may have a slightly bloated looking face, as I do in the photo above, which in my diary I called ‘fat’ and ‘puffy’, and which now looks terribly terribly tired—illness was exhausting, and recovery was even more so—but with a light of hopefulness in the eyes. Fat may also be deposited preferentially around your middle to begin with, to help protect vital organs. This is perfectly normal, and with time everything will even out, as long as you continue to be strict with yourself, and eat as planned. Remember that the body dysmorphia that often goes with anorexia—hich seems to manifest itself not just in explicit body representations and perceptions but also in automatic motor behaviours (Keizer et al. 2013)—won’t instantly be cured. But it will, with time, and consistent eating and consistent efforts to address its explicit aspects.

At an explicit level, articulated aesthetic ideals will take time to shift from their anorexic incarnations (staring enviously at catwalk models’ upper arms or whatever) to the acknowledgement of beauty in different, healthier kinds of bodies. While your articulated values still lag behind how your body looks, there’ll be all the discomfort of cognitive dissonance as you work towards a kind of body that you’ve spent so long finding reasons to reject—but it’s very important not to attempt to reduce that dissonance by eating less again, and instead to work on reducing it by seeking out and acknowledging alternative, more real, forms of beauty in people whose bodies support rich and varied lives rather than crippling them.

The more you can be patient, and take the long view, the more you’ll be rewarded in the end. My body four years ago, at (or just over) a healthy weight, was nothing like how it is today; part of this is due to the barbell training, but much of it is just time: time for fluid and fat to be redistributed, time for muscles and tendons to grow and be used and further strengthened, time for you to learn how to be at ease in your body and to get to know what it can do and what it can’t (yet). Nothing stays quite the same, ever, whether we want it to or not, but in the years following the restoration of a healthy bodyweight after anorexia, this constant mutability can be a source of delight, manifesting the human body’s miraculous ability to restore itself from the lowest point of deprivation. This depends, again, on bravery and strictness in resisting the urge to restrict and lose weight again because everything isn’t instantly how you’d like it to be. Give your body time, but also give it the best possible chance.

And it sounds awfully clichéd, but try not to fight against how your body is changing; embrace the changes. This is a mental attitude, but it’s one (like all mental states, indeed) that can be nurtured through specific actions. For example, don’t keep trying to wear all the same kinds of clothes you used to when you were ill; lots of them won’t suit you any more (though some may now look much better on you), and clinging to the old styles won’t help you move away from your anorexic body. Enjoy, ideally with other people, the journey of finding out what works for you now, but don’t expect everything to. Another thing that applies specifically to women, and which I found easy to embrace but which for others can be very difficult, is the newly feminine quality of your body, and – as noted in the diary entry – its now potentially sexual character. This was something that I’d completely failed to think about before I began to eat again, so consumed was I by worries about my tummy getting bigger, but the fact that I now began to have breasts again was actually quite a delight. Getting hips again was more difficult, but seeing that side of myself come back into being, and seeing others’ reactions change accordingly, made leaving skeletal behind much easier.

Stopping fighting your body by feeding its appetites again should go hand in hand with a willingness to be kind to it and to relearn how to listen to it. Obvious ways of doing this are things like massage, which can feel wonderful when your body is in the midst of such profound structural change. Slightly further along the line, yoga as part of outpatient treatment for adolescents with eating disorders seems to have beneficial effects on ED symptoms including preoccupation with food and anxiety and depression, with no negative effect on BMI (Carei et al. 2010). I’ve recently taken up yoga again—the last time I tried it I was still very ill—and it’s lovely to feel how it instantly attunes me more delicately to the capacities and limitations, in strength and flexibility, of all the parts of my body, and how it gives a calm context in which to stretch myself, literally and figuratively. Later still, strength training can have similar benefits, along with the added one of making you significantly stronger, with all its attendant benefits for cardiovascular health, bone and joint health, and metabolism. For women, post-anorexic or not, I think that getting physically strong can be a very potent way of declining to buy into anti-feminist equations of thinness (and hence weakness) with beauty, and for men recovering from anorexia, getting strong can be a way of reasserting your masculinity in the way that weight gain more generally naturally re-emphasises femininity. It shouldn’t be done too soon (maybe not till your bodyweight is healthy or close to healthy), and should be done with supervision, but for me, barbell training was a crucial factor in coming to understand, not just in the abstract but through the whole of me, that regaining weight was not just getting fatter, but was a fully constructive process of creating a newly beautiful, capable, dependable body for myself.

Remember that just as you have to contemplate constructing a character for yourself after anorexia, you have to construct a body for yourself too, one that will be what you need it to be for the adventure of being more fully alive in the years to come. Neither your character nor your body can be created from a blank slate, and especially after the control obsessions of anorexia, waiting and seeing what happens can be as empowering an attitude as taking things into your own hands, but the possibilities for what you can now let and help your body become, now it’s no longer trapped in the dangerous tedium of being skeletal and weak, are exhilarating. Enjoy them, with that mixture of strictness and openness which above all says: there’s time.

This makes so much sense to me, and I found it very reassuring to hear that things do become easier with time and perseverance. The cognitive dissonance between physical and mental changes is exactly where I am right now, and it is VERY uncomfortable. It is also scary because I know I still have further to go (not far probably in medical terms, but it feels a long way to me because of the significance I have given certain numbers) before being a fully healthy weight. The temptation is, as you say, to restrict in order to reduce the discomfort - it is familiar. But I know that will give me nothing good, and fully intend to keep going. Focusing on creating a body which is strong and capable of endurance and fitness, rather than being about bones and fragility is a really good strategy. I know comparing isn't always helpful, however after going away recently and looking at holiday pictures, I was able to see that in spite of recent changes I have made, my body still does not look healthy, compared to other women. And I would like to feel comfortable in a rounder, healthy body rather than needing to restrict and control to gain a false sense of security. I was able to look at women who are a higher (healthier) weight than myself and know that if I were a BMI of say, 20, I would look stronger, and strong and fat are not the same - and I will repeat that until I believe it!

I think for many people in recovery from restrictive eating disorders, being kind and compassionate to ourselves feels very foreign, especially when it comes to being kind to our bodies. I also think that character changes and physical changes, although they can't really happen exactly simultaneously, need to have some connection for recovery to work. Your post on constructing a character has helped me to think more about this.

Thank you for your blog Emily - I intend to use it as a tool to keep myself motivated on this journey, which on some days can feel so freeing and on other days leaves me feeling as trapped as ever. It can only get better if I keep going, right!

Yes, although comparisons can, given the cognitive distortions starvation brings about, often do more harm than good, they can also be a tool in the process of reconstructing a healthier value system when it comes to body image and so forth. I too hadn't really given any thought, while ill, to the fact that there isn't just thin and fat, or absence (relatively speaking) of bodyfat and presence (adequate or excessive) of it. When I finally realised that there's also muscle, and began to understand all that it can mean in terms of both aesthetics and functionality, that was the beginning of a new phase in my recovery. And ever since, the project specifically of getting stronger has been a major part of both bringing my body back to health and reconstructing my character after illness, and as such has brought home to me perhaps more strongly than anything else the inseverable connection that you refer to between mind and body.

And yes, it can all only get better with time, patience, and perseverance!

Thanks for this post, Emily! I've missed your posts :) And this one was particularly timely for me as I embark on the final stages of weight restoration for the...fourth time? I never successfully maintained a healthy weight for very long and I'm hesitating at this point remembering how bad it felt. But I never gave it enough time for me to adjust, and I was so rigid and AN-like in eating behaviour, with so many other unaddressed issues (OCD, depression, etc), that it wasn't really a workable situation. Not to mention I refused to go a gram above 20 BMI, so it's highly possible I was never actually at a healthy weight for me. I only had one toe in the recovery process really; the rest of me was firmly attached to AN. This time my outlook and attitude toward recovery are completely different, so I hope I will be able to stick with it for longer and observe your advice. I've bookmarked this post so I can return to it...

I'm very sorry it had been so long; as I just wrote in reply to another comment, I'd been working on a book that had got a bit all-consuming in the last few months, but it's done now, so I hope to post every month again from now on.

I'm really glad to hear that you're having another go at taking those final steps. They're such important ones: the ones that make the difference between being pretty much there and absolutely. I imagine it's very frustrating knowing that your body is so nearly at a weight at which it can be fully healthy, but being aware that you aren't quite able to let it get there. I remember well, too, how knowing that one looks healthy to other people but still feeling some of these anorexia-related problems remain so active leads to a painful sense of dissonance between appearance and actuality. Daring to put on those last few kilos can make all this melt away, and bring body and mind into a healthy harmony. (That sounds a bit corny, but the reality of it is truly beautiful.)

It's also brilliant that you feel so differently about it this time round. It's often hard to define exactly what has changed, but once you reach that point where it does all feel different, and most of the ambivalence that plagued you on previous attempts has been replaced by a steelier determination, everything is easier. The ambivalence never goes completely until the process is complete, of course, but if it's so much less now, there's no reason at all why you shouldn't succeed.

I know the feeling to be in a completely different place, I think as we grow and mature, we begin to realize the ED (ana) dose not fit and I know for me I know longer needed the attention ie from men, approval of girls and admiration from strangers, I think it was all very much a fine line as I got skinnier I still thought I was being admired its scary to think how my vunerability lead me to some risky places. I have attempted recovery time and time with support, rehab, therapy etc.! and now at 31 have decided to "re-feed" myself. Tho I seem to stick to certain foods in excess, and still feel bread, meat, heavier foods are too scary, fruit and veg easy pezy, I am still experiencing the weight gain as described in original post, face fat and mid section bloat. This can be uncomfortable and frustrating. Only thing that gets me through is 1: knowing it is perfectly normal part of the process. 2: hope 3: tomorrow is a new day. 4: Just for today. Live in this moment. Live for love. I have always wanted children, so will keep on this road for it is the road to life and love. I want to look forward to waking up, sitting down to meals, xmas and bdays, and all the events that truly come with turning my back on ED's and choosing a new far more fufulling life.

Thank you for this lovely comment, Amy. Those little mantras of yours are perfect. And those things you're aiming for, from having children to looking forward to waking up in the morning and everything in between, are beautiful goals to have set yourself. May 2015 be the year that lets many of them come true.

Thank you Emily, for your honesty and frankness in this and all your blog posts. Somehow you manage to put into words EXACTLY how it is to be entrenched in, and then recovering from anorexia. On multiple occasions I have been surprised at how you were able to articulate something I'd been feeling but could not put into words. Thank you, thank you; you help more than you probably will ever know you do :-)

I've read so many times how gratifying and 'perfecting' it is to be weight-restored. Just gain weight and that, alone, will help heal this wound. 30 years in, with obvious ebbs and floes, I feel like I'm on the cusp of recovery. I just need to know, 100%, that things will be okay. I so want to rid myself of this eating disorder. I can almost touch what it's like...on the other side. No pun intended, but I can almost taste it. I know that I want to be weight-restored; physically and psychologically. I just need to know that everything will be okay.

I wouldn't say 'perfecting', exactly; nor would I say it's like jumping off the edge of a cliff - I did that when I first decided to start eating more again. If I had to find a metaphor for it maybe I'd say it's like stepping from a dark tunnel into the bright light: it's the continuation of a process started long ago, but it's also a qualitative shift from dark to at least the possibility of full and lasting daylight. But the image isn't perfect because it doesn't quite convey the fact that there's still a path to be trodden, psychological work to be done to build on the newly strong physical foundation (to switch metaphors). But now, unlike before, the foundations are there to make that possible.

In any case, you are right on the cusp of being well again, and taking this step will make all the difference you hope it will and more. Things will be OK, and more than OK. If you feel ready now to let your eating disorder go, when your weight is healthy and you can think with normal flexibility again, when the long-term bodily repairs can finally be completed and your metabolism can return to normal - all of those things that can never happen if your weight stays where it is now - you'll only wish you'd done so sooner. Everything will taste better, because you'll be fully alive again. Let your weight increase to its natural level (and not just to the bottom of the 'healthy' BMI range) and all will be well.

HI Emily,
thank you for your article it has provided much comfort for me. I developed anorexia in january after a number of factors included my mum getting cancer left me craving control in my life. After resuming eating healthily again in June I am now in recovery. However, I have become severely depressed and can not bare the sight of my reflection now as my face is bloated and puffy. After reading you experienced similar symptoms I was comforted but I was wondering how long it took for your face to go back to normal and if there's any tips that will help it debloat. Please help- I feel unable to go on and can barely leave my room; at this point i am seriously considering dropping out of University despite being a perfectionist all my life. Now I just want to give up as I feel that I have already ruined my life. Please help.

1. If you feel you have clinical-level depression, you should see your doctor about it, and consider therapy and medication. If you are depressed, which given your mother's cancer and your anorexia wouldn't be at all surprising, things like your anxieties about your face will be much harder to deal with, and will contribute to intensifying the depression, so you need to tackle this vicious circle before it worsens.

2. Perfectionism is also something about which there are plenty of good self-help books available, so take it seriously as part of the constellation of factors which led to your illness and is likely to carry on making you unhappy, and do something about it, at some point when you're able. Perfectionism may always be a part of you, but it needn't be a dominant or defining part: you aren't (or shouldn't be) 'a perfectionist', just as you're no longer 'an anorexic'. You mustn't try to deal with everything at once, and this is probably something for later, but one day when other things are easier it would be well worth addressing, especially if you're planning on a challenging career in journalism.

Thanks for your reply Emily. Your response has given me great comfort. I know I sound ridiculously vain but I just want to look like me again. I have made an appointment with a doctor to speak about my concerns in a weeks time so hopefully that will help. I am having a hard time forgiving myself for what I have done, especially for causing my family more concern than they already had on their shoulders. I am just trying to get through each day eating healthily and hopefully things will get better with time. Instead of trying to reach for perfection I think just making it through university this year will be an achievement in itself. Thanks for the help and I will let you know about my progress.
Louise

No, you don't sound vain; I just wanted to try to convey a sense of perspective when it comes to this specific aspect of your appearance. I really hope your visit to the doctor was helpful, and do try not to give the feelings of guilt too much space - you never chose to become ill, and you are now doing your best to get better. That is all anyone - including yourself - can ask of you. And as you say, keeping on with your studies is in itself not an insubstantial challenge for this year.

Do let me know how things have progressed, if you like, and good luck with it all.

I went to a doctor and massage therapist who both confirmed it wasn't water retention. I must assume it is redistribution of fat. I was looking back on photos taken throughout my illness and beyond and its almost as if half way through the composition of my face changed if that makes any sense. I don't even recognise myself anymore.The fat that was stored in the top of my cheeks appears to be lingering around the sides of my mouth. Is this common and do you believe it will ever normalise?
Looking at old photos upset me as it was a reminder of what I have done.My family suggested I try therapy but after a few sessions the therapist has referred me onto Cognitive Behavioural Therapy treatment. As much as I want to get better I don't think any amount of therapy/drugs/support will help because I hate the shell I made for myself and can't help but feel I have ruined my life and things will never change. On top of everything else my mum has restarted chemotherapy after the cancer had spread to her lungs and liver. My family try and sympathise but I don't think they understood how sick I really was (and still am) as I was able to hide it well from them (and to some extent myself) while at University. Plus, knowing my mum is fighting cancer whilst the only thing I am fighting is myself makes me feel even worse- as I know I need to stay strong for my mum. On top of that my periods have still not normalised and only come in every 2 months which is also frustrating. Sorry to be such a debbie downer. I still hope there's light at the end of the tunnel- but I'm really struggling to see it at the moment.
Best wishes,
Louise

Thanks for the 'progress' report, and well done for getting yourself checked out by the doctor and massage therapist. I've never read or heard much about fat being deposited specifically in the face, but the general redistribution process takes many months or even years, so your main attitude at this stage should, as far as possible, probably be patience. There's certainly no reason to assume at this early stage that it won't normalise, so I suggest you work on the assumption it will do. I know it's hard to have faith in the healing power of time - it just never seems to take effect quickly enough! - but it really can work wonders. (The same goes for your periods, by the way.) If I compare the shape and size of my face right at the end of the weight-gain phase (about 4.5 years ago) and now, the difference is dramatic, but the change has happened only gradually, very much in its own time rather than in mine.

Have you started the CBT sessions yet? I hope you'll find them helpful; I certainly think that paradigm is likely to be more effective than others in treating eating disorders, because it actively targets the destructive behaviours in conjunction with the thought patterns and emotions which they sustain and are sustained by. In short, it actually encourages you to *do* things differently, rather than just talk about it.

It's perfectly natural to feel despairing and consumed by self-loathing at times like these, but you must try to remember that you won't always feel this way, and that the 'shell' you've made for yourself - or rather, that has ended up, through a combination of your own actions and others' and environmental factors, being created - is *not* indestructible. Your life is *not* ruined, and things will change. And you're doing exactly the right thing to start to demolish the shell, bit by bit. One day you'll look back on these experiences of illness and recovery and know that while they damaged you for some time, they ultimately contributed to strengthening you.

I'm so sorry to hear about your mother. Of course that must make your situation much more difficult, but you mustn't draw too categorical a distinction between the illnesses the two of you are suffering from. All eating disorders, and in particular anorexia, are profoundly physical illnesses as well as psychological ones, and it simply isn't a question of it all being in your head. Of course, the mental resistance to weight gain is part of it, but malnutrition has so many effects that you have to take it seriously as central to your condition.

The instinct to want to prove to others just how sick one is, and just how hard recovery is, even once one has decided to get better, is very common in eating disorders, and I know the ambivalence you feel must be exacerbated by your contrasting desire to be strong for your mother and the rest of your family. But I'm sure none of them doubts how seriously ill you've been; on the contrary, as I'm sure you know, your illness will have been a major source of worry and sadness for them for as long as it's been with you. For your mother in particular, I'm sure that seeing you healthy again would give her more happiness than almost anything else. And even if, as is highly unlikely, they didn't fully understand the gravity of it - so what? Does trying to make them see what they've failed to all this time constitute a good reason for letting yourself stay ill and watching more of your life slip away? At some point you'll have to stop worrying about what other people may or may not think - after all, you can never know for sure - and simply take ownership of your own life again. This is your future we're talking about, not anyone else's.

In any case, I hope the new year might provide a little motivation to make changes and stick to them. I hope, too, that your mother is as well as can be expected.

My name is Edith. I am 15 years old, and I have only just begun my recovery after being released from the hospital due to a potassium deficiency, which was due to purging as well as restricting. I am now eating 6 small meals a day and I am supervised at all times. At the moment my body isn't used to all the food being kept down, and since the cells and organs in my body are repairing themselves my stomach is very bloated. I honestly want to be healthy and I know that the path I was going down was incredibly dangerous, but I can't stop obsessing over my belly and the way my body is changing. Yesterday I was crying because my bones were starting to disappear, and I couldn't explain to my mother that I liked my anorexic body even though I tried to hide it from her with layers of clothing. I know that its a mental illness thats affecting my perception but she just gets angry at me and is convinced that once I take my antidepressants I'll be 'all better'. She doesn't seem to understand that my eating disorder was about trying to be happy with my body as well as controlling a certain aspect of my life-my weight and shape. At the moment I am finding it so hard to accept my body as it becomes healthy again, and even though it's only been a week, the changes are definitely noticeable. One of the reasons I became anorexic is because I felt like I had no true passions or goals to work towards, and therefore no direction or motivation. I felt like I was mediocre and not eating made me feel strong, in control and in some ways.....superior to my friends (which I know is not right). I felt like i could excel at something that others found difficult to, which was losing weight , and losing weight felt like such an achievement. I have convinced myself that I was happy as I lost more weight in my thin body, since I feel disgusting at the moment. I know that I have so much help and support around me, but it's hard. I am eating and cooperating, but hating myself more and more and slowly starting to feel more worthless every day. Anyway, my mother is trying to understand and help me through this and she found what you've written and showed it to me. I've read every word of it and it makes me feel less alone. I feel like there are so many others out there that understand, and I know that I have only been anorexic since the beginning of this year, but reading what you've written has really helped me and is a great comfort. I still desperately want to be skinny again, but I know that it won't really make me happy. I know that I've just said a lot of things about myself but I feel isolated at the moment and this is my way of trying to let my emotions out, which is funny because I am not usually a very emotional person. Anyway, I just want to thank you and tell you that your work has inspired me to get better. Even if you don't read this and never respond, I am just happy that I said this.
So thanks
Sincerely

Thank you for your message, Edith, and your very kind words about my blog; I'm sorry for the slow response, and am so glad to hear that my writing has been one of the inspirations in your decision to get better.

I remember very vividly the fear and despair of seeing the body that during my illness I'd grown, in that profoundly ambivalent way, to love and take comfort in start to change beyond recognition. It's so difficult watching all the angular markers of extreme thinness and therefore (to one's still starvation-distorted mind) of control, strength, and superiority gradually be softened away and filled in as you regain weight. But it does help, I think, to remind yourself that precisely this filling-in is what your body has been needing and longing to do, and that its progress towards a new and currently frighteningly unknown size and shape is fundamentally self-protective and restorative - this is about your body finding its way back to a place of health and stability, a place where your mind, too, will be able to be healthy and stable - and happy - too. Right there in the very parts of your body you find hardest to contemplate just now, this is life fighting back against sickness, and winning.

It's also worth bearing in mind - maybe even writing a list to refer back to when things are tough, as they inevitably will be sometimes - the reasons why, even just at the physical level, recovery will be positive: being able to go out without covering up your body in cold or embarrassment, for example, or being able to rely on it to be strong and capable and a support to you in all the activities that anorexia makes impossible.

As for those pernicious illusions of control and superiority, it sounds as though you really have come to accept that they are in a completely fundamental sense illusions, and that's a completely crucial step towards successful recovery. Starving yourself may have started as an exercise of self-control or self-discipline, but at some point that tipped over into illness, and from that point onwards, you were simply enslaved to anorexia, and not in control at all any more. And, well, of course starving yourself never made you superior to anyone, least of all your friends - it made you different, but the difference was isolating and debilitating rather than anything admirable. But you already know that.

It doesn't seem to be possible for everyone, but I did find that once I'd made the decision to eat more again, I was able to deliberately harness the willpower that I'd previously exercised in refusing food and controlling my bodyweight in a negative direction, and turn it inside out. From now on, I was going to be just as strong and determined as I'd always thought I was being - but for real now, in the positive, constructive direction of letting my body heal itself, of giving it the reliable source of energy it needed to do so. Maybe you can see whether your mind will let you think like that about the whole thing? It requires a bit of a trick of altered vision, like when you have to squint a bit to see one of those visual illusions, but I found it became easier and easier, as the months of recovery went by, to stay seeing things that good and life-affirming way rather than falling back into the old ways of thinking and acting. And then at some point - really quite quickly, actually - eating more stopped requiring an effort of will, and became something I could do spontaneously and with pleasure.

I'm very glad to hear that you have lots of supportive people around you, but it's also completely natural to feel isolated despite them all, and to feel that they don't know what you're going through. They don't - how could they? - but they do love and care about you and want to do all they can to help, even though they may sometimes be scared by your illness and their own inability to fully understand. So do tell them, as gently as you can, when they say or do things that are unhelpful - but tell them, too, when what they're doing really is helping. Above all, take what you need for now, and don't worry too much if it seems selfish at times - in these difficult weeks and months, you need to focus on you and your recovery; it will take all your energy, and not leave much left over for working out how best to be with other people, but that's OK. This too will become much easier with time.

Indeed, the main thing I want to say is that I hope you'll believe me when I say that as you continue to regain weight, everything will get easier, when it comes to social interactions and all the food-related stuff, and all other areas of life. Every meal you manage to eat makes the next one easier, till at some point, you'll begin to realise that you don't find the changes in your body quite so hateful, or that you don't feel quite so worthless, or you'll notice that you've started to take more of an interest in something that isn't food-related, or connecting in a new way with an old friend, and then you'll know that you're really on the way to recovery.

Just remember that being skinny never made you a worthwhile human being, and nor did it make you happy; beyond the crucial practicalities of weight restoration, recovery is a process of rediscovering yourself and accepting what you find. It's a frightening process - but an exhilarating one too, realising that you needn't be constantly at war with yourself, and that being at peace with your desires and preferences, however simple, is all right, and good, and can make you happy.

Finding new interests and things to work towards that weren't work- or weight/shape/food-related was certainly a challenge for me, but over time I've found things: little things like watching DVDs and reading for pleasure again, realising how much I love driving, taking up sports I've become good at like powerlifting, having a go at activities I'm really not good at like ice-skating or surfing. And most of all, social stuff - learning to love just hanging out with people eating and drinking and talking and whatever. I think it's important not to get too fixated on the grand notions of passions and goals, and think first of all about expanding your everyday horizons in more modest ways. With a more varied yet relaxed life comes a relaxed and open and therefore engaged and *interested* mind, and from that position, new passions will probably arise. But for now, let the inevitable weariness and preoccupation of recovery run its course, and don't push instantly for achievements and successes. They're what anorexia demanded of you so mercilessly, so in rejecting anorexia you need also to reject that constant drive to do better, and learn simply to be.

Gosh, sorry if that all sounds hopelessly Zen! All I really wanted to say was congratulations on getting this far, and that it really will get easier with every passing week. And, not least (if belatedly), that you're never alone.

Hi Emily, I was just scrolling down after reading a few posts, yrs being 1st, and realized most were 2013, so found the last entries 2014. I just wanted to confirm you would see my post, I replied above, my name is Amy, I feel like I need to reach out and find a humble acceptance of the changes I am experiencing. Ps I am a Kiwi Chicky. From Nelson, NZ currently live Picton with soon to be Hubby and soon to be step son lol.
Thank you for this post, far more helpful then searching for idols in the media etc..! for this is what you are offering for others. It is reassuring to know more about this problem, I have learnt recently it is far more common then I realized which is disturbing yet satisfying. It must lose its glamour and power. For it is false. I meet genuine, real people now, that is power, freedom and honestly what we are ALL worthy of in this life.

Thanks for this comment too, Amy, and I'm sorry for the slow response; I've only just realised that something must have gone wrong with my email notifications for new comments over the past month or so.

I'm very glad this blog has been helpful to you, and I completely agree with you that although realising how prevalent these problems are can be unsettling, ultimately the knowledge that they don't make you special is deeply empowering. As you say, we're all just human beings, who need food and drink both to survive and, more than that, to be happy.

Dear Emily, Thank you so much for your articles that I have read and reread through my entire recovery. You have been incredibly amazing. I'm 18 years old, and have been weight restored for about 9 months, but my weight has continued to increase. It has been stable now for around 4/5 months. However I am almost overweight on the BMI scale, (which I know I should ignore) but I am not comfortable with my weight. Do you think it will decrease? I tried eating healthier and exercising but my weight still didn't move.
I'd appreciate it so much if you could answer. And thank you again for being such an inspiration!

Congratulations on getting this far in your recovery, Maria, and I'm really glad if my blog has been of some help.

It's completely natural not to feel comfortable with your newly healthy body for a while, and patience is probably the best thing I can advise, even though it doesn't make for very satisfying advice.

In relation to this, it's important not to think of being 'weight restored' as reaching a BMI of, say, 19 or 20; you have restored your weight when you get to the weight *your* body needs to be at. So in your case, assuming your weight stabilised without you resorting to dietary restriction, you have been weight restored for only for 4 or 5 months, and in general the evidence suggests that redistribution of body fat, for example, takes up to a year, and total bodyweight 'overshoot' around the same. Certainly that was the case for me - possibly a bit longer for the body fat.

By all means start incorporating exercise into your weekly routine as of starting to increase your strength and fitness, to get in touch with your body in constructive ways, and for its social benefits and simply as something fun, but don't attempt to use it as a weight-loss strategy. Whether or not that were successful, which it probably wouldn't be (exercise is a deeply inefficient as a driver of weight loss), it could only ever end up undoing the brilliant physical and psychological progress you've worked so hard to achieve. Dietary restriction is much the same; you should of course be working on incorporating more variety into what you eat, and there can now perhaps be less emphasis on calorie-dense foods than there needed to be during the weight-gain phase. But again, the aim should absolutely not be to systematically reduce your energy intake, rather to nurture a more inclusive way of eating and incorporating food into the rest of life (for example through meals as social activities, relaxed cooking as a means of self-care, and so on).

Real recovery from serious illness takes time. It's easy to think that the hardest work is done once a stable bodyweight has been reached. In some respects that's true - the crucial basis for living well has now been established - but in other respects, the work that requires the most bravery and determination is still to come. Now is the time when you have to start not working towards health, but living it; not sidelining everything else for the sake of weight gain but working out how to balance weight maintenance with the other things that matter to you in life. Of course, how you feel about your own body is one of these things, but that will still take time to adjust to all that's changed - and as I say, the physical changes will still continue for many months yet.

I'm sorry not to be able to offer much more concrete suggestions than patience, but I think it really is crucial at this still precarious stage in recovery. So many people seem to relapse around now, so do all you can to make sure you don't. The crucial thing to bear in mind is that while all of society may seem to be screaming at you that thinner is better, this distorted value system absolutely does not apply to you now. You've brought yourself back from the depths of a life-threatening illness, and maintaining and building on your physical strength and wellbeing is your single strongest defence against ever returning there.